Anxiety & Motherhood

by

alk held on Thursday 26th August 2010 for volunteers of the Mum To Mum Program At The Jewish Women’s Association

The key objective of the Mum to Mum program is to help mothers successfully cope with the postnatal months thus promoting healthy and nurturing family attachments. Although motherhood is a natural process the adaptation of a new mother to her role is challenging and influenced by many factors, including the availability of a support system.

MUM TO MUM TALK ON ANXIETY

by Genevieve David, BA, Masters in Clinical Social Work, Adv. Diploma Adult Psychodynamic Psychotherapy

Issue of anxiety in motherhood

15 – 20% WOMEN DURING THE CHILD BEARING YEARS WILL BE EFFECTED by depression or anxiety! That is 1 in 5, which suggests that at least 3 women will be affected in this room.

I believe that we are only seeing the tip of the iceberg as we will see there are many factors that prevent mothers from sharing their feelings.

As you well know the changes women undergo as they go through pregnancy to motherhood are enormous.  This period requires enormous adjustments.  These adjustments can cause everything from normal anxiety to anxiety leading to depression, particularly after a traumatic birth but also normally just after having a baby.

The incredible physiological changes during pregnancy, during birth, and  motherhood can cause various levels of anxiety.

Pregnancy and birth cause enormous emotional turmoil (which can become anxiety) in the area of social roles and responsibilities.  A woman’s changing roles and responsibilities when she becomes a mother are enormous.  It changes the nature of her relationship to her husband, to her friends, to her own family of origin (mother, father, brothers and sisters) and her friends.  It’s no wonder many of us can’t cope; we are forever changed by this experience as well as our world.

As well as physiological changes and social changes women also have to accommodate to changes in identity.    Enormous changes in life and the many uncertainties that accompany them are cause for anxiety.  Questions new mothers are often asking themselves: Who am I?  Am I who I want to be? Am I doing what I want to be doing?    These questions often come with various degrees of anxiety.

The most commonly talked about identity crisis is midlife, particularly midlife in men.

Interestingly, motherhood is not so frequently talked about as a crisis.  Perhaps it’s believed that because we are biologically made to have babies we are also able to mother those babies without much fuss.  This is not true and in traditional society it wasn’t true either.  Anxiety was perhaps always a problem for mothers but they had social supports and cultural supports that gave her the opportunity to recover.

As we have become more consumer- oriented and more goal -oriented we have also become more and more isolated, individuated and nomadic.  This has not bode well for mothers.

In the Daily Telegraph two weeks ago as I was preparing this talk I came across an article about the pressures that mothers face today and identified a new book being launched next year: From Mousewife to Momshell: The Rules and Celebrity Secrets for being Thinner, Younger, and Sexier Mum.

The article criticized the toxic effect of body conscious celebrities in recent years.  The public scrutiny of models and actresses who weeks after their babies are born put themselves in the public eye, sometimes even in bikinis showing off their bodies and faces ‘seemingly’ untouched by their new motherhood has spurred an interest in another how to …book.   “Just as we resigned ourselves to yummy mummy we now have momshell.”  She also highlights some other very worrying developments that are being seen in a high proportion of pregnant mothers: “pregnorexia,” an eating disorder during pregnancy that is recognised by over -exercising or purging and/or excessive dieting.  And the “mummy make-over” which includes a tummy tuck, a breast lift and minor liposuction this has been packaged up for women eg. in Thailand.   These are all related to some kind of anxiety.

The problem of anxiety in mothers is not going away.

Anxiety and how to recognise it

  • It is a mixture of sensations, feelings and thoughts and can range from healthy to unhealthy anxiety.
  • Let me try and illustrate the difference between healthy anxiety and unhealthy and the edge that some of us often live in.
  • Here is an example I came up with to illustrate what happens to us when we are anxious it’s not just a sensation.
  • When you gather a bunch of things in your arms to carry up some stairs.

I think we all have an intuitive sense of when you have a load in your arms that feel just right and if you were to put another item in your load that this would be pushing the balance and it could be ok but at the same time it could be the point at which it all collapses.  “I can carry one more thing, I can fit one more thing into my arms it’ll be fine…but there is a niggling voice that says “don’t do it!” When we are centred and mindful we hear and listen to that voice.  When we are somewhat anxious we may not feel like we can’t afford to listen to that voice and when we are over anxious we don’t even hear the voice it’s a do or die situation, and so what happens is that we might not just put one more thing but two or three more things and then we inevitably drop the load.   And with dropping the load comes confirmation of “I’m so bloody hopeless, so so dumb, I can’t even carry things up the stairs…” “What the hell was I thinking… did I take …what a bloody idiot…” and so on…over and over during a day, judging, criticising, in actual fact hurting oneself… and science has proven that the same part of the brain that lights up when it is physical pain is lit up when there is criticism you are hurting yourself creating pathways in the brain that whittle away at ones self confidence.

Co -created anxiety

  • When we are anxious it can sometimes to be very hard to feel anxiety in others so I thought it might be helpful to talk about some of the signals of anxiety that we may be able to see in mums even if we are prone to anxiety in ourselves.
  • Ruminating self-defeating words…  “I should have” or “should be”  “I could have,”  “why didn’t I ..”  “I can’t…,” “I don’t know how,” “I’m so stupid..” –
  • When you have a sense of a person rushing,  being easily distractible, being vague, having tangential thoughts, a  person who organises lists,
  • Never leaving anything to chance, people who plan everything.
  • Obsessive cleaning or tidying.
  • Anxiety is very common and it is also very contagious. If we are feeling anxious with a new mother she is going to feel our anxiety and this will exaggerate her own.
  • And oftentimes if a mother is anxious which she will be, most likely, then we also run the risk of becoming anxious ourselves, even if we went in without feeling anxious before.
  • Therefore it is really important to become aware of your own feelings when you are in a helping role.

Because it’s anxiety that exaggerates our need to fix things for others; when we are anxious we naturally try and get rid of the unwanted feelings in ourselves by fixing the other.

For example when a new mother says: “my baby didn’t sleep at all last night I’m not getting it right I’ll never get it right..” saying something that is empathic like: “Babies are exhausting and being a new mum brings up lots of doubts about getting it right, but look how healthy/happy your baby looks.”

RATHER THAN “you’ll be alright” OR “this is what I think you should do”

Join with the mother where she is, find a way to be with her feelings whether it is despair or with excitement.  This will reduce her anxiety.

But it does require that as carers that we need to become aware of what is being triggered in ourselves; are we feeling anxious about the baby or the mother are we attached to the baby having a routine? The mother breast- feeding? Mum getting more sleep? The baby sleeping with the mother? Or in it’s own room? Etc. etc.

Anxiety can come from many different areas and can start from the birth and continue through.  In a new mother it can come from the birth trauma, from lack of mothering role models and therefore a “not knowing,” and an embarrassment, of “not measuring up” to the image of motherhood that one imagined for oneself, or that is portrayed in the media.  It can be about not being as competent as one is used to being, this is particularly seen in women who have been used to feeling competent in the world.

The toxicity of anxiety in particular in mothering is that it makes us lose touch with our intuitive wisdom, this is particularly important in a new mother.  We no longer feel our bodies, our senses: our smell, touch, taste, sight.   And our intuitive senses are dulled because they are consumed by our thoughts (thinking mind), and our doing, both of which protect us from feeling; day and night our minds are at work with lists of things to attend to that fill our days with doing and avoid being with the uncomfortable feelings that “being” brings up again “not measuring up” etc.

The symptoms of a mother who is overly anxious and perhaps requires some outside assistance is:

Waking at three in the morning tossing and turning:

  • “Why did I have to….
  • I sounded…behaved….looked…like an idiot.  What did they mean….?
  • I knew I wasn’t good enough….
  • If only….”

AND Not able to fall back to sleep because of the rumination.

Or feeling a great weight as she gets up in the morning thinking:

“Why do I feel so bad I have everything I ever wanted, a loving husband, supportive family, friends, nice house and now baby.  Why can’t I pull myself together, this is so stupid I should….”

Imposing very strict rules on a baby (most often destined for failure because babies don’t know that they are supposed to follow the rules but they can feel that mum is anxious and so feel anxious themselves and can’t settle or feed when it is imposed on them.)

The importance of regulation

We cannot over emphasize the importance of helping mothers to regulate their feelings.   The effect of regulating the mother has so many benefits.  In particular, for you today is to know how important the work you do to is to help mum increase her pleasure in her baby by supporting her, this will increase her ability to resonate with her baby and this will increase the likelihood of a healthy attachment between the mother with her baby.

A highly anxious mother cannot have a securely attached baby, which is why it is so important for us to work together to help mum regulate herself.  The essential features of a secure attachment, result among many things in improved feeding, sleeping and learning.  They are also extremely important in the baby’s future relationships.

An anxious mother will be distracted by her thoughts we all have a sense of this – if you think about what you are going to make for dinner while I continue to talk to you, you will quickly lose track of what I have said.  There is a continuum of distraction from normal to abnormal, among a more highly anxious group and in particular first time mums and first time mum’s with problem births this may reach such levels that the mum’s are not cuing into their babies signals, which requires a high level of attunement, a mum who is very present and can attend to all the signals, verbal and non-verbal.  And important is mum’s ability to use herself, her own senses and intuitions to relate to her baby.

Here is an extreme story of a mum whose anxieties completely overwhelmed her connection to herself and to her baby.  She became completely distracted and disconnected from her baby…In the morning she went to work and as usual drop her daughter off to day care.  When she came out of work and got into her car at the end of the day her daughter was still in the car – dead.  She thought she had dropped her off but had been so preoccupied that she had forgotten.

How anxiety can become depression?  When anxiety is present for a long time one begins to feel hopeless and defeated.  If we look in the natural world it’s like a mouse that is continually taunted by a cat until the mouse gives up and lies defeated and powerless – that’s depression.

What you can do as a carer?

  • Do what you are doing….just being yourselves warm, compassionate mother’s helping mothers is exactly what is needed here.  Being the mother that they didn’t even have, or are far away from is essential to their success as a mother.
  • Anyone who has suffered….will tell you how normalizing a mother’s feelings and talking about the socio-cultural issues that perpetuate the feelings helps reduce anxiety.
  • Becoming aware of your own anxiety and your mother’s anxiety
  • Trauma needs therapy but other kinds of anxiety including panic attacks can be treated using:
  • Mindfulness based meditation –

Briefly, the effect of mindfulness based meditation is to slow down the brain.  It helps people become better able to aware of the present moment as it is … to become aware of thoughts, feelings and sensations…as they are right now.  As you become more present -focused you have a technique to quieten the anxious mind which when practiced regularly, daily, will retrain the mind and reduce the anxiety significantly.

  • This affects 3 important hormones: reduces cortisol which interferes with learning and memory (stress hormone from the adrenal gland), DHEA which is a component of all hormones (also made by the adrenal gland) and a key determinant to feelings of vibrancy and health, and melatonin which is a hormone that helps with restful sleep which helps with quality of life.  It is also a powerful antioxidant.
  • Meditation also helps with the left and right balance of the brain’s functioning increases creativity, insight, learning, problem solving and memory.
  • Encourage your mum to contact the anxiety clinic, beyond blue, black dog or a registered psychologist, psychotherapist or clinical social worker OR meditation teacher, mindfulness course such as open ground, yoga course.

At the Red Tent we feel that its not a given to become a mother.

Our philosophy is that mothers need lots of help.  Like Hilary Clinton with the help of her mentor and teacher Jean Houston wrote: It takes a village to bring up a child.

Why help mothers to be mothers?

  • It is assumed that as women we should know how to be a mother.
  • It is assumed that if we wanted to become pregnant that we were wanting to become mothers and they are not necessarily true statements.
  • It is assumed that we as women know what we are getting into.
  • It is assumed that we are comfortable giving up our very well-ordered, successful lives to become mothers.
  • And so when the birth doesn’t go as planned
  • When the baby isn’t following the book.
  • When your body isn’t as it was.
  • When your partnership has changed and your role has changed

…not surprising that we feel so unsure

Where to from here?

Read up on acupuncture for women’s health

Read up on Pregnancy, Birth and Postpartum care